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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by susan C on July 16, 2001, at 16:54:48
What is this called? Treatment resistant? Drug resistant, recalcitrant, stubborn? breakthrough?
Posted by SalArmy4me on July 16, 2001, at 17:06:26
In reply to tried everything, nothing works, posted by susan C on July 16, 2001, at 16:54:48
Tell me everything you have tried and I'll give you 5 new and viable choices of medication.
> What is this called? Treatment resistant? Drug resistant, recalcitrant, stubborn? breakthrough?
Posted by susan C on July 16, 2001, at 18:23:38
In reply to Re: tried everything, nothing works » susan C, posted by SalArmy4me on July 16, 2001, at 17:06:26
Here we go...I hope this makes sense:
I have your list of March 2, 2001
Things that worked: combo of trazadone/prozac and progesterone for about 5 years (yahoooo!) Alpha Stim 12 months, Serzone 9 months, Depakote/Ambien for sleep 8 months.
I am so in awe of the detail of your posts…how do you get it all and keep it organized!? good luck in Mexico. I remember a story about my dad coming thru customs with two buckets, they say, what is in those buckets, he says, I am a neurologist, the buckets contain brains, do you want to see them? Just tell them you are carrying brains. I am in tough swing now, have to ‘take beating’ thought the ‘dullness’ of depakote was unfortunate, but now, I would like to be back there.
Dx bipolarII/genetic/rapid cycling, some days up and down, Month 8 of depakote, something changed this week, no hair fall out, not sleeping as much. Stress, confict triggers depression, manic ? Other things that have changed, exercising more in last couple of weeks.
Suggestions/investigations: Hypercoagulation, VNS, thyroid (.75), Levetiracetam, experimental treatments
Things I remember trying : first pdoc: Trazadone, lithium, progesterone, prozac, buspar,
wellbutron, effexor, other ssri?, estrogen(s)have requested records so I know for sure.current pdoc: lamotrigine, topomax, tegrital, depakote,
and
ND: Compounded progeterone/triestrogen HRT for hotflashes in menopause. DHEA taking multi and other vits.Asthma: flowvent/alubeuteral/accolate symptoms have been less this week also. hmmmmm
Some blood tests are boarderline, was very anemic (exhuberent blood donation) but OTC iron took care of that. I should probably avoid SSRIs.Thank you.
> Tell me everything you have tried and I'll give you 5 new and viable choices of medication.
>
> > What is this called? Treatment resistant? Drug resistant, recalcitrant, stubborn? breakthrough?
Posted by SalArmy4me on July 16, 2001, at 19:33:47
In reply to Re: tried everything, nothing works, posted by susan C on July 16, 2001, at 18:23:38
I was thinking about selegiline, mirtazapine, pindolol augmentation of something you have already taken, reboxetine, moclobemide, lithium augmentation, naltrexone, or atypical neuroleptics with antidepressant properties (risperidone, olanzapine, quetiapine, ziprasidone).
> Things that worked: combo of trazadone/prozac and progesterone for about 5 years (yahoooo!) Alpha Stim 12 months, Serzone 9 months, Depakote/Ambien for sleep 8 months.
>
> Dx bipolarII/genetic/rapid cycling, some days up and down, Month 8 of depakote, something changed this week, no hair fall out, not sleeping as much. Stress, confict triggers depression, manic ? Other things that have changed, exercising more in last couple of weeks.
Things I remember trying : first pdoc: Trazadone, lithium, progesterone, prozac, buspar,
> wellbutron, effexor, other ssri?, estrogen(s)have requested records so I know for sure.
>
> current pdoc: lamotrigine, topomax, tegrital, depakote,
Posted by Janelle on July 16, 2001, at 19:48:24
In reply to tried everything, nothing works, posted by susan C on July 16, 2001, at 16:54:48
SusanC - don't give up! I know how you feel. I have yet to find the "right" a-d for me and I'm feeling so frustrated and IMPATIENT. I wish these things would kick in right away. The waiting period is soooooooo hard to bear.
I'm not nearly as informed as others on this board, but it sounds like there's a lot of meds that you have NOT tried yet that could work. Looks like SalArmy4Me gave some possibilities.
Good luck!
-Janelle
Posted by Janelle on July 16, 2001, at 19:52:40
In reply to tried everything, nothing works, posted by susan C on July 16, 2001, at 16:54:48
I don't think I caught anywhere that you have tried Paxil (paroxetine) - that worked grrrrrreat for me till I developed BipolarII/hypomania. Just a suggestion. Paxil is an SSRI, yet works on Norepinephrine as well, and is "officially" recognized as being good for social anxiety and OCD type stuff (though it did not help me with my obsessive and compulsive tendencies).
-Janelle
Posted by susan C on July 16, 2001, at 22:06:33
In reply to Re: tried everything, nothing works, posted by SalArmy4me on July 16, 2001, at 19:33:47
Thanks for all the suggestions. Right now I am on Depakote and I thought it would help and maybe it is and I am just having a 'break through'. Levetiracetam and olanzapine i had come across and I will look these meds up and try to be informed when I see pdoc next week. Again, I really appreciate all your work...you are kind of like an angel, always here, always with something to suggest, but unlike an angel, you always seem to have something very solid to suggest or describe..good luck south of the border.
> I was thinking about selegiline, mirtazapine, pindolol augmentation of something you have already taken, reboxetine, moclobemide, lithium augmentation, naltrexone, or atypical neuroleptics with antidepressant properties (risperidone, olanzapine, quetiapine, ziprasidone).
>
> > Things that worked: combo of trazadone/prozac and progesterone for about 5 years (yahoooo!) Alpha Stim 12 months, Serzone 9 months, Depakote/Ambien for sleep 8 months.
> >
> > Dx bipolarII/genetic/rapid cycling, some days up and down, Month 8 of depakote, something changed this week, no hair fall out, not sleeping as much. Stress, confict triggers depression, manic ? Other things that have changed, exercising more in last couple of weeks.
> Things I remember trying : first pdoc: Trazadone, lithium, progesterone, prozac, buspar,
> > wellbutron, effexor, other ssri?, estrogen(s)have requested records so I know for sure.
> >
> > current pdoc: lamotrigine, topomax, tegrital, depakote,
Posted by susan C on July 16, 2001, at 22:09:37
In reply to Re: tried everything, nothing works » susan C, posted by Janelle on July 16, 2001, at 19:48:24
Thanks for the cheer. Paxil has never been suggested and because I am rapid cycle if I undertand how it works it wouldn't be a good idea because it would be more manic. Family history of depression, schiz and seizure.
> SusanC - don't give up! I know how you feel. I have yet to find the "right" a-d for me and I'm feeling so frustrated and IMPATIENT. I wish these things would kick in right away. The waiting period is soooooooo hard to bear.
>
> I'm not nearly as informed as others on this board, but it sounds like there's a lot of meds that you have NOT tried yet that could work. Looks like SalArmy4Me gave some possibilities.
>
> Good luck!
> -Janelle
Posted by JohnL on July 18, 2001, at 18:44:36
In reply to tried everything, nothing works, posted by susan C on July 16, 2001, at 16:54:48
> What is this called? Treatment resistant? Drug resistant, recalcitrant, stubborn? breakthrough?
Nope. It's called 'aint tried the right one yet'. Though the title to your post says you've tried everything, there isn't enough time in a lifetime to try everything.
Prozac+Zyprexa together?
Amisulpride?
Adrafinil?
Ritalin?
Adderall?
Risperdal?
Any combination of the above?We each have very particular unique genes, chemistry, personalities, and circumstances. Sometimes the difference between a drug that works and one that doesn't is just a tiny minute molecular detail. For example, on paper Adrafinil and Provigil look identical. In my own trials, one was totally horrible and the other totally wonderful. It only took a tiny seemingly insignificant difference for my body to either embrace or reject the particular drug.
I too at one time said I had tried everything. That was before I tried Prozac+Adrafinil+Zyprexa. Prozac+Amisulpride is good to me too. Don't give up. Look where you haven't looked. Concentrate on the list above.
John
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